Novel biomarkers in heart failure: usefulness in clinical practice

Abstract

Biomarkers have become an increasingly important tool in clinical practice, helping to improve patient care. In heart failure (HF), brain natriuretic peptide and N-terminal prohormone of the brain natriuretic peptide have been widely applied in prognosis, clinical diagnosis and treatment. Recently, several novel biomarkers have been examined on their efficacy to improve diagnosis, determine the pathophysiologic state of HF, improve clinical decision making, clinical outcome, guide treatment and assess prognosis of HF patients. In this special report, the authors summarize the usefulness and significance of the most promising novel biomarkers in patients with HF.

Keywords::

• biomarkers
• cardiovascular disease
• diagnosis
• heart failure
• prognosis
• treatment

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Brain natriuretic peptide (BNP) and N-terminal prohormone of BNP have been widely applied in prognosis, clinical diagnosis and treatment of heart failure (HF).

• Recently, several novel biomarkers have been examined for their efficacy to improve diagnosis, determine the pathophysiologic state of HF, improve clinical decision making and clinical outcome, enable direct treatment and assess prognosis of HF patients.

• Mid-regional pro-atrial natriuretic peptide has been considered by the updated guidelines as a very reliable test for the diagnosis of HF. Mid-regional pro-adrenomedullin levels added to the utility of BNP levels in obese patients with intermediate BNP values.

• ST-2 and galectin-3 might have an encouraging impact on clinicians' decision, reaching better understanding of the pathogenesis of heart failure.

• Growth differentiation factor 15 significantly improved reclassification for the diagnosis of HF and added incremental value to N-terminal prohormone of BNP.

• MiRNAs might become a target for therapy in HF, by the development of miR-mimics.

• Renal tubular damage markers, such as neutrophil gelatinase–associated lipocalin and cystatin C, are very useful for the treatment of patients with HF and kidney disease.

• Combination of two or more biomarkers for the evaluation of HF patients seems a possible and appealing solution and might be used in the enhancement of the diagnostic and prognostic power.